13D2177132 CLIA NUMBER - DIRECT DOCTOR CARE

Laboratory Demographics

  • CLIA Code: 13D2177132
  • Facility Name: DIRECT DOCTOR CARE
  • Facility Address: 509 S MIDDLETON RD STE 105
    MIDDLETON, ID
    ZIP 83644
  • Facility Phone: 208 688-2080
  • Facility Type: Community Clinic
  • Facility Type: Waiver
  • Lab Director: ROGER WYATT
  • NPI Number: 1871112094
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 13D2177132
LAB Type Community Clinic
Facility Name DIRECT DOCTOR CARE
Street 509 S MIDDLETON RD STE 105
City MIDDLETON
State ID
ZIP 83644
Phone 208 688-2080
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/6/2024
Certificate Expiration Date 1/5/2026
Facility Type Community Clinic
Lab Director ROGER WYATT

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This page was last updated on: 9/29/2025